“These essays are getting harder to write,” I told Dad on another trip home from the doctor.

“I know,” he said.

We didn’t say anything else; there wasn’t anything else to say.

I’ve become a procrastinator when it comes to evaluating our situation–I spend far more time skirting the computer, searching for little distractions. And plenty of them offer themselves up to me, from the practical to the completely irrelevant. I take all comers, because then I can avoid writing the next entry about Dad.

And Dad’s pretty good, for someone with Stage IV metastatic prostate cancer. But the okay-ness is dribbling away as the easy options become less easy, and Dad becomes less healthy.

Dad weaned himself off the oxycodone because he hated being loopy (and worse, being plugged up like the Colorado River behind the Hoover Dam), and he’s much happier for it. His solution to the painkillers, re-framing his problem as being less about pain and more about mobility, has worked wonders for him, though I’m not sure whether it’s mind over matter or sheer stubbornness which tipped the scales. His hip bones, deteriorating because of the cancer living within, are being blasted with the newest round of radiation therapy and there is hope that once he’s done with ten days in the nuker, he’ll be less hobbled and more mobile once again.

It’s his PSA numbers which hang most ominously overhead these days. Six weeks ago when the blood tests revealed a return of the cancer into full bloom, the doctors put Dad on Casodex, a drug which was supposed to bolster the hormone therapy’s efficacy and to stomp down whatever little bit of testosterone was left. In doing so, it was hoped that his numbers would level off, maybe even go down again. Instead they’ve risen fairly precipitously, despite the Casodex. And since his testosterone is practically undetectable but his numbers are rising anyway, one can extrapolate that the cancer just isn’t taking “no” for an answer any more.

The doctors have been, if not silent, not particularly specific in explaining Dad’s options for us. This is one of the hallmarks of our experience: a sense of anxiety as we wait to discover what the various tests reveal, and then having to sit with the results while other things fall into place. In our current situation, it means that even though we know Dad’s cancer is zooming into high gear, we’re waiting for his system to clear of any remnants of the Casodex (six weeks) before they offer him other therapies.

These other therapies are mostly going to be clinical trials, which is a whole new kettle of fish. Because Dad seems to have run out of other options, the only one’s left are the hinky ones which aren’t approved for anyone but those with the most aggressive cancers which have defied all other treatment. This gives one pause. We’re at the point where none of his decisions are easy ones: the fork in the road when Dad will decide whether the choices offered are worth the bother for the potential “x” number of months more to live. What will the quality of those “x” months be? How much will the therapy affect his well being? Is it worth it?

That’s a deep question, one which will be interesting to go through, though I’ll admit I don’t fancy the process. There’s a peculiar type of logic involved, the cost-benefit ratio of living and dying. If these as-yet un-offered therapies are going to lay Dad out for a few weeks, but then give him an earnest few extra months of relatively unencumbered life, is it worth the effort expended? Put another way, if the therapies statistically offer Dad two or four extra months of life but make him sick as a dog while he’s going through it, is it good enough? Or is it more important to call a spade a spade and enjoy what is left without the medical interventions and scheduling and errands and invasions that constitute late-stage cancer care?

We’ve got a few weeks to chew on this.

•  •  •

Portland is finally warming up in earnest. Early spring was relatively mild, but the weather had a little personality disorder and decided to make April wintry again. Now that the sun is bright and the light can fall on Dad again, he’s opening like a flower. It’s a tonic for him; every day with sun and warmth is a precious gift.

Dad has always burned hotter than your average human, and as such he kept the heat down too low in his house for his reptilian daughter’s taste. I was always cold in our house (except in summer, when our house was so hot and stifling that I sometimes crawled out my brother’s window to sleep on the flat part of our roof), and I’m often chilly in his current little bungalow. Dad’s a conscientious, conservation-minded soul who, no matter the weather outside keeps his thermostat at a sensible 68 degrees. At night the thermostat is set to “Arctic.”

As his health is declining, it’s confusing to see him bundled up when the air has only a slight crispness to it. When I grab his hand in the doctor’s office, it’s often cold. He wears a jacket no matter the weather anymore, and he’s almost always dressed in a wool sweater, making him looking like a fisherman on the coast of Ireland facing down some Atlantic sea blast, not a Portlander facing another moderate day in the low to mid-sixties.

So each warm day is worth its weight in helium since it gives Dad just that little extra bit of comfort. It provides the opportunity to bake out the aches in his bones and to nap in its rays. It allows him the perfect light to paint under, clean brightness falling through the skylights in his studio, released of the bonds of Portland’s overcast murk.

But the other side of the coin (there’s always another side to the coin) is that there will be a time when there are no more pleasant days again. Fall will come, bringing with it the damp cool that seems to bother Dad more and more as the cancer becomes entrenched. So I’m of mixed mind about the usually mundane weather–I’m glad that it’s beautiful now so that Dad can bask in the glory of Portland’s spectacular spring, but I wish that I could stop time and the weather so that, if Dad begins to decline in earnest, he does so at the pinnacle of beauty and light. I do not want Dad’s light to fade as the weather does.

But we don’t choose these things, do we?

•  •  •

I was at sixes-and-sevens with my son yesterday, so exasperated that I called my husband to run interference. It’s possible that my exasperation with my son was made up of some part weariness and some part stress, though to be fair he was being a complete pill.

I left my son and my husband to walk the wonderfully uncomplicated dog, who’s only desire is to please me, chase small objects and eat things he shouldn’t. If I find his missing chewy ball, I am the conquering hero. If I train him to sit, I’ve mastered a secret language. To walk him is to be loved by him.

On my way home along a narrow path, an elderly couple was walking towards me, inching along, the woman providing stability for her companion who was shaky on his feet. They paused to let me by. “No, you first,” I said, pulling up the dog to make room.

“We’re pokey,” the woman said.

“That’s okay,” I said.

“We’re pokey, but we’re nice people,” she said.

“That’s the most important thing,” I replied.

She insisted I make my way past them, and I did, but not without a tinge of sadness and remorse. Remorse that they felt rushed on my behalf, that the woman felt the need to apologize for being old and slow. There should be no apologies, no need to justify one’s value as a nice person because you’re out for an evening walk along a narrow path. With any luck, I’ll have my husband’s arm to guide me when I’m slow, or he mine, or we each other’s. If so, I hope I don’t feel compelled to apologize for my age or my infirmity, though I probably will.

I hate that on top of everything else, on top of all the indignities and depredations of age and illness, that anyone feels compelled to apologize for existing.

•  •  •

We drove home one afternoon from another of Dad’s countless doctor’s visits. We had just gotten word that his numbers, despite the Casodex, were continuing to climb. We were in a pensive mood.

“I guess it’s back,” I said.

“Looks like it,” Dad agreed.

“You’re going to have to think about what kind of medical interventions are worth the candle.”

“I have been,” he said. “Mostly I hope to see Chris. That’s all.”

The only important things left are to be with those he loves, not how much time remains.

•  •  •

In the middle of all this, my brother Chris has experienced a professional windfall. Through fiat and a little craftiness, he’s set himself up for a nice career boost, but to attain this brass ring he’s committed himself to a long stint in a faraway land. He waits for updates about Dad’s health from me, full of anxiety and hopefulness in equal measure. The news, unfortunately, is not good. So while he’s juggling chainsaws in his new professional role, he’s waiting for news which, when it arrives, only makes him want to drop the chainsaws and come running here.

Dad is sanguine about all this. “He’s doing exactly what he needs to do right now,” he said.

When I told Chris this, he scoffed. “Sure, easy for him to say.”

“He misses you,” I said. It was meant to be comforting; only after it left my lips did I realize that it was salt in the wound. Chris misses Dad profoundly, deeply, wants to be here, but can’t leave his post right now. To remind him of Dad missing him was a lightning strike straight to his exposed tender bits.

I felt compelled to apologize for existing.

•  •  •

These essays are getting harder to write. The medical options being presented have less obvious benefits, the therapies akin to putting out brush fires when there’s a conflagration raging. Dad’s lovely radiation doctor, with whom he has a chaste infatuation, called his radiation therapy at this late stage “spot welding:” if something hurts, they’ll zap it to make him feel better; if the cancer threatens to encroach too far into his spine or certain organs, they’ll beam their mighty rays of doom at it. But there’s no stopping the cancer. It’s too deeply embedded in the very make-up of Dad now; he and it are wedded until the end.

While the essays are harder to write, the days are enjoyable for the most part. I’m tired, a little wistful, have some hopes for how I would like things to be which perhaps border on the fantastical. But Dad, despite his cancer and the narrowing field of options available to him, remains cheerful. His wants are few, and revolve around the people in his life who matter to him. He laughs easily. He’s writing about meaningful moments in his life, packing up books. He paints cheeky little paintings about his cancer while I avoid writing about it.

I just dished up some ice cream for my son, smack in the middle of the warm May afternoon. Instead of making dessert contingent upon his eating some proper food, which is how our day started going south yesterday, I’m embracing the teachable moments Dad shares with me by giving my son ice cream just because I love him and life is short. The one dish of ice cream without my nagging is more valuable than the dubious health benefits of two more bites of whatever remains on his plate.

For today, anyway. But that’s all we have.

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